Knee osteoarthritis phenotypes and their relevance for outcomes: a systematic review

Deveza, Leticia A; Melo, Luciano; Yamato, Tiê Parma; Mills, Kathryn; Ravi, Varshini; Hunter, David J.

doi:10.1016/j.joca.2017.08.009

Cited by 220 publications

(196 citation statements)

References 59 publications

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“…There is a need to better understand the complete spectrum of characteristics involved in this heterogeneous disease to improve characterization of knee OA sub-types. [39] In order to do so, we need to clearly document, define and analyze changes in cellular response,[40,41] extracellular matrix,[42–44] tidemark and SCB [45–48] that are important to the structure and function of cartilage. This is an important aspect from therapeutic perspective also, in order to improve the efficacy of the treatments, by identifying various possible OA sub-groups for targeted treatment procedures.…”

Section: Discussionmentioning

confidence: 99%

Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation

Mantripragada

Piuzzi

Zachos

et al. 2017

Current Research in Translational Medicine

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Objective The two main objectives of the study include 1) Test the hypothesis that the lateral femoral condyle (LFC) in patients with primary OA and varus knees undergoing total knee arthroplasty (TKA) can be used as a model to better characterize varying histological features of human OA. 2) Correlate characteristic OA features using the established histopathological scoring systems (HHGS and OARSI) to understand potential histopathological patterns of OA initiation. Design Two osteochondral specimens (4×4×8mm) were collected from fifty patient’s LFC at the time of TKA (total 100 specimens), who presented preserved lateral knee compartment with joint space width >2mm. Three independent readers graded the sections on three different occasions using HHGS and OARSI systems. The correlation between individual parameters of the two scoring systems and their inter- and intra-reader variability, reliability and reproducibility were estimated. Results All samples in this cohort showed abnormal histopathological features. Total histopathological scores of the LFC ranged from HHGS median=4.6 (range=0 to 11), and OARSI median=5.2 (range=0 to 19.5). The four individual sub-items of HHGS scoring system (structure, cells, safraninO staining, tidemark) were weakly correlated, with the correlation between structure and cellularity being the strongest (r=0.40). Both the scoring systems had similar repeatability and reproducibility coefficients of <21%. Conclusions OA changes in the LFC are not confined to any one region, and maybe seen in different regions of cartilage, tidemark, subchondral bone, and/or the marrow space vascularity. These variations may point to the possibility of several potential patterns of initiation in OA.

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Section: Discussionmentioning

confidence: 99%

Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation

Mantripragada

Piuzzi

Zachos

et al. 2017

Current Research in Translational Medicine

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“…Последние годы интерес исследователей прив-лёк вопрос о разнообразии форм проявления ОА, реализующихся на молекулярном, структурном, клиническом уровнях [3]. Особую актуальность представляет идентификация структурной гете-рогенности ОА.…”

Section: âведениеunclassified

“…В связи с этим было высказано мнение, что прогрессирование и клинический ста-тус определяется не стадией, а фенотипом забо-левания [4]. Несмотря на живой интерес к данной проблеме, до настоящего времени отсутствует общепринятая классификация и диагностические критерии структурных фенотипов ОА, разработка которых должна способствовать более глубокому пониманию патогенеза и способов лечения [3].…”

Section: âведениеunclassified

“…Ранее рядом авторов было предложено выде-лять субхондральный и хрящевой субтипы ОА [2,3]. В связи с этим возник закономерный вопрос о факторах и механизмах развития того или иного фенотипа.…”

Section: âведениеunclassified

“…При этом субтипе ОА отмечена большая толщина стенок подколенной, верхнелатеральной и меди-альной артерий. По-видимому этим обусловлено более тяжелое течение остеоартрита у больных с субхондральным фенотипом, который харак-теризуется выраженным поражением суставного Примечание: * -различия статистически значимы по z-критерию Манна-Уитни по сравнению с хрящевым фенотипом, p<0,05. хряща и СХК [3]. Тяжесть сосудистого ремодели-рования при субхондральном фенотипе определя-лась и снижением сосудистого индекса, который, в известной мере, характеризует перфузинонные резервы сосудистого русла.…”

Section: результаты и обсуждениеunclassified

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The Role of Vascular Remodeling in the Formation of Structural Phenotypes of Osteoarthritis

Кабалык¹,

Невзорова²

2018

Kuban. nauсh. med. vestnik

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Федеральное государственное учреждение высшего образования «Тихоокеанский государственный медицинский университет» Министерства здравоохранения Российской Федерации, пр-т Острякова, д. 2, г. Владивосток, Россия, 690002ABSTRACT Aim. Evaluation of the role of vascular remodeling in the formation of structural phenotypes of osteoarthritis (OA). Materials and methods. 62 patients with OA aged 65,9±8,8 years and 18 volunteers without clinical and roentgenologic signs of OA aged 60,7±7,9 years were examined. All patients underwent magnetic resonance imaging of knee joints. To analyze the structural changes in the tissues of the knee joint, the WORMS protocol was used for magnetic resonance imaging. The thickness of the vascular wall, the external diameter, the vascular index (VI) were measured -the ratio of the diameter of the lumen of the vessel to the thickness of the popliteal artery (PA) wall, the branch of the upper lateral artery (LA), the medial artery of the knee (MA).Results. The analysis of the parameters of the arteries of the knee joint showed that with a subchondral OA phenotype, the thickness of the PA wall is statistically significantly larger than the cartilage phenotype, and the vascular index of the PA is significantly higher in the group of the cartilaginous phenotype. The upper LA wall was significantly thicker in the subchondral OA phenotype. VI of the upper LA was significantly lower in patients with a subchondral phenotype compared

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Guidance for Implementing Best Practice Therapeutic Exercise for Patients With Knee and Hip Osteoarthritis: What Does the Current Evidence Base Tell Us?

Holden

Button

Collins

et al. 2021

Arthritis Care & Research

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to address this gap, we aim to synthesize current literature informing the implementation of therapeutic exercise for people with knee and hip osteoarthritis.Methods: Narrative review focusing on evidence from systematic reviews and randomized controlled trials.Results: Therapeutic exercise is safe for people with knee and hip osteoarthritis. Numerous types of therapeutic exercise (including aerobic, strengthening, neuromuscular, mind-body exercise) may be utilised at varying doses and in different settings to improve pain and function. Benefits from therapeutic exercise appear greater when dosage recommendations from general exercise guidelines for healthy adults are met. However, interim therapeutic exercise goals may also be useful, given that many barriers to achieving these dosages exist among this patient group.Theoretically-informed strategies to improve adherence to therapeutic exercise, such as patient education, goal setting, monitoring and feedback, may help maintain participation and optimise clinical benefits over the longer-term. Sedentary behaviour is also a risk factor for disability and lower quality of life in people with knee and hip osteoarthritis, although limited evidence exists regarding how best to reduce this behaviour. Conclusion:Current evidence can be used to inform how to implement best practice therapeutic exercise, at a sufficient and appropriate dose, for people with knee and hip osteoarthritis. Significance and Innovations.1. Therapeutic exercise is safe for people with knee and hip osteoarthritis, and contrary to the common lay belief, does not lead to further joint damage.2. Numerous types of therapeutic exercise (including aerobic, strength, neuromuscular and mind-body exercise) can be performed at varying dosages and in different settings, to improve pain and function in people with knee and hip osteoarthritis.

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Knee osteoarthritis phenotypes and their relevance for outcomes: a systematic review

Abstract: PROSPERO CRD42016036220.

Cited by 220 publications

References 59 publications

Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation

Histopathological assessment of primary osteoarthritic knees in large patient cohort reveal the possibility of several potential patterns of osteoarthritis initiation

The Role of Vascular Remodeling in the Formation of Structural Phenotypes of Osteoarthritis

Guidance for Implementing Best Practice Therapeutic Exercise for Patients With Knee and Hip Osteoarthritis: What Does the Current Evidence Base Tell Us?

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